FORUM 2 Ethics in Hospice Palliative Care and Informed Consent
1 .Ethical issues on hospice palliative care Co-Shi Chantal Chao, Ph.D. (Taiwan)
Ethical Issues on Hospice Palliative Care
by Co-Shi Chantal Chao, Ph.D.
Director of Hospice Program
Catholic Sanipax Socio-Medical
Service & Education Foundation
There are at least five ethical issues on hospice palliative care in Taiwan. Those are CPR vs. DNR, Patient Self-determination, Advance Directives, Withhold & Withdraw of Life-Support System,
and Euthanasia vs. Natural Death. I would explain each of them in detail.
1. CPR vs. DNR (Cardiopulmonary Resuscitation vs. Do-Not-Resuscitate)
We all know that DNR is a routine on hospice palliative care. CPR violates the bio-medical ethical principles of beneficence and nonmalefcence. Nevertheless, we still use CPR on some terminally
ill cancer patients in our hospices according to the patients' relatives' requests. Of course no patient was ever rescued by this technique.
The reason why we use CPR on medical futility cases is that we have Physician's Law, No.43. The threaten of malpractice law suit impedes our ethical decision making. The solution for this problem
is to revise this law(No.43, Physician's Law) and to educate the public about CPR vs. DNR. We hope to learn from other countries how to deal with this problem.
